Long Term Disability

Long Term Disability (LTD) applies to insurance policies typically issued to employers for the benefit of employees. They are governed by a federal law known as Employee Retirement Income Security Act (ERISA). Don't be misled by the term "Security" in the Act. ERISA results in almost anything but security for the disabled employee. ERISA grants broad discretion to insurers in deciding who will be entitled to the benefits. It is a very onerous act, especially in the way it has been interpreted by the federal courts. The cards are most definitely stacked against the employee who files for disability under one of these policies. Some typical insurance companies that write disability insurance are... UNUM, Liberty Mutual, and Jefferson Pilot.

Typically the employee is covered for some percentage of her salary. For the first two years she is considered disabled if unable to do her past job; thereafter she is considered disabled only if she cannot perform any job. Other benefits, such as Social Security Disability and Worker's Compensation are deducted from the benefit amount. For example, if the employee was making $3,000 per month and is covered for 60%, and if her Social Security benefit is $1,200 per month, her benefit amount is $1,800 minus $1,200 or $600 net.

As you can see there is some interplay of Social Security benefits with Long Term Disability benefits. Often one is dependent to some extent on the other and pursuing LTD and SSD simultaneously is the most desirable method.

For claims filed in 2002 and thereafter the applicant has 180 days to appeal the denial letter. Some policies allow for a second appeal before the case is taken to court. The appeal deadlines are very important. The insurance company will use the deadlines to defeat the claim.

Of equal importance, during this period the applicant should be proving her claim with documentation because once the administrative appeals are exhausted no more documentation is allowed. Nevertheless, sometimes the case can be salvaged even if a time limit is missed. Contact Herren Law Office for consultation regarding such situations. There is no fee for consultation.

Because of the pitfalls in applying for LTD, claimants should contact a lawyer early in the process. Many lawyers do not handle LTD claims. Of those that do, many charge fees up front and charge hourly fees for services whether or not the case is won. Herren Law Office works on a contingent fee... meaning that we get paid if successful but there is no fee if the case is lost. The fee is a percentage of the recovery.
 

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